摘要
目的比较超敏C反应蛋白(hs-CRP)、降钙素原(PCT)、白介素6(IL-6)、中性粒细胞与淋巴细胞比值(NLR)对肺部细菌感染和肺炎支原体感染的早期诊断价值。方法收集于2020年12月~2021年2月在自贡市第一人民医院初诊的肺部感染性疾病患者131例,其中细菌感染组72例、肺炎支原体感染组59例。收集两组患者的一般临床资料,对所有受试者进行血细胞分析、IL-6、hs-CRP、PCT检测。比较hs-CRP、PCT、IL-6和NLR对细菌感染和肺炎支原体感染的鉴别诊断价值。结果细菌感染组hs-CRP、PCT、IL-6和NLR值均高于肺炎支原体感染组,差异有统计学意义(P<0.05);细菌感染组和肺炎支原体感染组比较,PCT、hs-CRP、IL-6、NLR的ROC曲线下面积(AUC)分别为0.915、0.859、0.831、0.858,诊断截点分别为0.49ng/ml、38.33mg/L、19.50pg/ml、4.82;PCT的诊断敏感度为88.9%,特异性为86.4%,约登指数为0.75;hs-CRP的诊断敏感度为75.0%,特异性为84.7%,约登指数为0.60;IL-6的诊断敏感度为73.6%,特异性为81.4%,约登指数为0.55;NLR的诊断敏感度为79.2%,特异性为79.7%,约登指数为0.59。结论血液PCT、IL-6、NLR、hs-CRP测定对于鉴别诊断细菌性感染和肺炎支原体感染有较高的临床价值,PCT的诊断价值最高。
Objective To compare the clinical diagnostic value of hypersensitive C reactive protein(hs-CRP),procalcitonin(PCT),interleukin 6(IL-6),neutrophil to lymphocyte ratio(NLR)for Pulmonary bacterial infection and mycoplasma pneumoniae infection.Methods 131 patients withpulmonary infectious diseases were admitted to the Zigong First people′s Hospital from December 2020 to February 2021,including 72 cases of bacterial infection,and 59 cases of mycoplasma pneumoniae infection.The clinical data were collected and blood routine,hs-CRP,PCT and IL-6 were tested for all subjects.The differential diagnostic value of the four test indexes on bacterial infection and mycoplasma pneumoniae infection was compared.Results The hs-CRP,PCT,IL-6,and NLR values of bacterial infection group were higher than those of mycoplasma pneumoniae infection group(P<0.05).Between bacterial infection group and mycoplasma pneumoniae infection,the area under ROC curve(AUC)of PCT,hs-CRP,IL-6and NLR was 0.915,0.859,0.831 and 0.858,respectively,and the diagnostic cutoff value was 0.49ng/ml,38.33mg/L,19.50pg/ml,4.82,respectively.The diagnostic sensitivity,specificity and Youden index of PCT were 88.9%,86.4%and 0.75,respectively.The diagnostic sensitivity,specificity and Youden index of hs-CRP were 75.0%,84.7%and 0.60,respectively.The diagnostic sensitivity,specificity and Youden index of IL-6 were 73.6%,81.4%and 0.55,respectively.The diagnostic sensitivity,specificity and Youden index of NLR were 79.2%,79.7%and 0.59.Conclusion The determination of PCT,IL-6,NLR and hs-CRP has high clinical value for the differential diagnosis of pulmonary bacterial infection and mycoplasma infection,and PCT has the highest diagnostic value.
作者
刘伟平
毛小倩
Liu Weiping;Mao Xiaoqian(Department of Clinical Laboratory,Zigong First People′s Hospital,Sichuan 643000,China)
出处
《医学研究杂志》
2021年第12期64-67,135,共5页
Journal of Medical Research
基金
科技部国家重点研发计划项目(2019YFF0216501-Z51)。
